tbuckley/cabot-search huggingface dataset:
Safety and efficacy of kidney transplantation in patients with aortoiliac stenosis: a retrospective cohort study
Authors: Yitian Fang, Julie J.M. Hamm, Floris P.J. den Hartog, Hendrikus J.A.N. Kimenai, Ron W.F. de Bruin, Robert C. Minnee
Journal: International Journal of Surgery (2023)

Background: The impact of aortoiliac occlusive disease on kidney transplantation remains unclear. This study aims to investigate the clinical outcomes of kidney transplant patients with aortoiliac atherosclerotic stenosis. Methods: Retrospective data from our transplant center were used to identify patients undergoing kidney transplantation between January 2010 and December 2020. Aortoiliac atherosclerotic stenosis was screened and stratified by the Trans-Atlantic Inter-Society Consensus (TASC) II classification. The primary outcome was patient survival. Secondary outcomes were 90-day mortality, death-censored graft survival, graft function and arterial complications. Propensity score matching was used to match all patients in the stenosis group with patients without stenosis sharing similar characteristics. Results: The analysis included 655 patients, 524 without stenosis, and 131 with aortoiliac stenosis (95 with TASC A/B stenosis, 36 with TASC C/D stenosis). Recipient age (median [IQR], 66 [60-70] vs. 66 [59-71] years; P =0.47), gender (male: 87 [66%] vs. 355 [68%], P =0.85), and comorbidities were comparable between the stenosis and no-stenosis groups. Forty-six (35%) patients with stenosis were symptomatic. Patient survival was significantly lower in the stenosis group compared to the no-stenosis group (TASC A/B: 30.6% vs. no-stenosis: 44.1%, P =0.013; TASC C/D: 11.4% vs. no-stenosis: 44.1%, P &lt;0.001). The incidence rates of artery dissection, lower extremity ischemia and acute thrombosis were significantly higher in the stenosis group ( P &lt;0.001). However, death-censored graft survival (TASC A/B: 73.6% vs. no-stenosis: 72.9%, P =0.62; TASC C/D: 58.1% vs. no-stenosis: 72.9%, P =0.16) and graft function were comparable between the groups. Conclusions: Aortoiliac atherosclerotic stenosis significantly impacts patient survival but not graft survival. Our analyses suggest that patients with TASC A/B stenosis have prolonged survival and enhanced quality of life through kidney transplantation. However, for patients with TASC C/D stenosis, kidney transplantation improves quality of life without bringing survival benefits.
A commentary on ‘Iron replacement therapy in iron deficiency anemia: a perspective revisited for low-and middle-income countries’
Authors: Haitao Xu
Journal: International Journal of Surgery (2023)

Department of Hematology, Anqing Municipal Hospital, Anhui, 246000, China Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Department of Hematology, Anqing Municipal Hospital, Anhui, 246000, China. E-mail address: [email protected] (H. Xu). This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
Bibliometric analysis of three-dimensional printing applications in cardiovascular diseases: a correspondence
Authors: Wu-Xia Quan, Ji-Wei Geng, Wen-Yu Luan, Fang Zhang, Yan-Dong Miao
Journal: International Journal of Surgery (2023)

Quan, Wu-Xia; Geng, Ji-Wei; Luan, Wen-Yu; Zhang, Fang MD; Miao, Yan-Dong MD Author Information
Intraoperative blood pressure and cardiac complications after aneurysmal subarachnoid hemorrhage: a retrospective cohort study
Authors: Juan Wang, Fa Lin, Min Zeng, Minying Liu, Maoyao Zheng, Yue Ren, Shu Li, Xiaodong Yang, Yiqiang Chen, Xiaolin Chen, Daniel I. Sessler, Yuming Peng
Journal: International Journal of Surgery (2023)

Background: Previous studies report that intraoperative hypotension worsens outcomes after aneurysmal subarachnoid hemorrhage (aSAH). However, the hypotensive harm threshold for major adverse cardiovascular events (MACE) remains unclear. Methods: The authors included aSAH patients who had general anesthesia for aneurysmal clipping/coiling. MACE were defined by a composite of acute myocardial injury, acute myocardial infarction, and other cardiovascular complications identified by electrocardiogram and echocardiography. The authors initially used logistic regression and change-point analysis based on the second derivative to identify mean arterial pressure (MAP) of 75 mmHg as the harm threshold. Thereafter, our major exposure was MAP below 75 mmHg characterized by area, duration, and time-weighted average. The area below 75 mmHg represents the severity and duration of exposure and was defined as the sum of all areas below a specified threshold using the trapezoid rule. Time-weighted average MAP was derived by dividing area below the threshold by the duration of anesthesia. All analyses were adjusted for baseline risk factors including age greater than 70 years, female sex, severity of intracerebral hemorrhage, history of cardiovascular disease, and preoperative elevated myocardial enzymes. Results: Among 1029 patients enrolled, 254 (25%) developed postoperative MACE. Patients who experienced MACE were slightly older (59±11 vs. 54±11 years), were slightly more often women (69 vs. 58%), and had a higher prevalence of cardiovascular history (65 vs. 47%). Adjusted cardiovascular risk increased nearly linearly over the entire range of observed MAP. However, there was a slight inflexion at MAP of 75 mmHg. MACE was significantly associated with area [adjusted odds ratios (aOR) 1.004 per 10 mmHg.min, 95% CI: 1.001–1.007, P =0.002), duration (aOR 1.031 per 10 min, 95% CI: 1.009–1.054, P =0.006), and time-weighted average (aOR 3.516 per 10 mmHg, 95% CI: 1.818–6.801, P &lt;0.001) of MAP less than 75 mmHg. Conclusions: Lower blood pressures were associated with cardiovascular complications over the entire observed range, but worsened when MAP was less than 75 mmHg. Pending trial data to establish causality, it may be prudent to keep MAP above 75 mmHg in patients having surgical aSAH repairs to reduce the risk of MACE.
Enhancing precision and efficiency: harnessing robotics and artificial intelligence for endoscopic and surgical advancements
Authors: Vimalraj Selvaraj, Swathi Sudhakar, Saravanan Sekaran, Suresh Kumar Rajamani Sekar, Sudha Warrier
Journal: International Journal of Surgery (2023)

Selvaraj, Vimalraj; Sudhakar, Swathi; Sekaran, Saravanan; RS, Suresh Kumar PhD Author Information
Identification of the consistently differential expressed hub mRNAs and proteins in lung adenocarcinoma and construction of the prognostic signature: a multidimensional analysis
Authors: Yiran Liu, Zhenyu Li, Qianyao Meng, Anhui Ning, Shenxuan Zhou, Siqi Li, Xiaobo Tao, Yutong Wu, Qiong Chen, Tian Tian, Lei Zhang, Jiahua Cui, Liping Mao, Minjie Chu
Journal: International Journal of Surgery (2023)

This study aimed to elucidate the consistency of differentially expressed hub mRNAs and proteins in lung adenocarcinoma (LUAD) across populations and to construct a comprehensive LUAD prognostic signature.
Impact of Bevacizumab Being Skipped due to Adverse Events of Special Interest for Bevacizumab in Patients with Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab: An Exploratory Analysis of the Phase III IMbrave150 Study
Authors: Masatoshi Kudo, Kaoru Tsuchiya, Yu-Yun Shao, Richard S Finn, Peter R Galle, Michel Ducreux, Ann-Lii Cheng, Tatsuya Yamashita, Hironori Koga, Ryosuke Take, Kyoko Yamada, Takashi Asakawa, Yuki Nakagawa, Masafumi Ikeda
Journal: Liver Cancer (2023)

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; The phase III IMbrave150 study established atezolizumab + bevacizumab as the global standard of care in patients with unresectable hepatocellular carcinoma (HCC). This exploratory analysis examined the impact of bevacizumab interruption due to bevacizumab adverse events of special interest (AESIs). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Patients in IMbrave150 who were randomized to atezolizumab + bevacizumab and received treatment for ≥6 months (to reduce immortal time bias) were included in group A-1 if bevacizumab had ever been skipped due to bevacizumab AESIs or to group A-2 otherwise. Efficacy analyses included overall survival (OS) and progression-free survival (PFS) by whether bevacizumab was skipped (group A-1 vs. A-2). PFS was evaluated per independent review facility (IRF)-assessed Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1 and HCC-modified RECIST (IRF-HCC mRECIST). Safety was also evaluated. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Of the 210 patients who received ≥6 months of atezolizumab + bevacizumab, 69 were assigned to group A-1 and 141 to A-2. At data cutoff (August 20, 2020), hazard ratio (HR) for OS was 1.04 (95% CI: 0.64, 1.69) for group A-1 versus A-2. HR for PFS was 1.07 (95% CI: 0.74, 1.55) per IRF-assessed RECIST 1.1 and 1.10 (95% CI: 0.76, 1.59; 15.5 vs. 9.7 months) per IRF-HCC mRECIST for group A-1 versus A-2. Safety profiles for atezolizumab and bevacizumab were largely similar between groups. More group A-1 patients had grade 3/4 adverse events. A separate analysis investigating the impact of immortal time bias in patients who received ≥3 months of atezolizumab + bevacizumab supported the appropriateness of the ≥6-month landmark analysis. &lt;b&gt;&lt;i&gt;Discussion/Conclusion:&lt;/i&gt;&lt;/b&gt; Efficacy was similar between patients who skipped bevacizumab due to bevacizumab AESIs and those who did not. Although this comparison was nonrandomized and exploratory, results suggest that skipping bevacizumab due to bevacizumab AESIs did not considerably impact the efficacy and safety of atezolizumab + bevacizumab.
A Multicenter Phase 2 Trial Evaluating the Efficacy and Safety of Preoperative Lenvatinib Therapy for Patients with Advanced Hepatocellular Carcinoma (LENS-HCC Trial)
Authors: Akihiko Ichida, Junichi Arita, Etsuro Hatano, Susumu Eguchi, Akio Saiura, Hiroaki Nagano, Junichi Shindoh, Masaji Hashimoto, Nobuyuki Takemura, Kojiro Taura, Yoshihiro Sakamoto, Yu Takahashi, Yasuji Seyama, Yasuharu Sasaki, Kohei Uemura, Norihiro Kokudo, Kiyoshi Hasegawa
Journal: Liver Cancer (2023)

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; The phase III REFLECT trial demonstrated that lenvatinib was superior to sorafenib in terms of progression-free survival (PFS), time to progression, and objective response rate (ORR) for patients with unresectable hepatocellular carcinoma (HCC). This study assessed the efficacy and safety of preoperative lenvatinib therapy for patients with oncologically or technically unresectable HCC. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; In this multicenter single-arm phase II trial, patients with advanced HCC and factors suggestive of a poor prognosis (macroscopic vascular invasion, extrahepatic metastasis, or multinodular tumors) were enrolled. Patients with these factors, even with technically resectable HCC, were defined as oncologically unresectable because of the expected poor prognosis after surgery. After 8 weeks of lenvatinib therapy, the patients were assessed for resectability, and tumor resection was performed if the tumor was considered technically resectable. The primary endpoint was the surgical resection rate. The secondary endpoints were the macroscopic curative resection rate, overall survival (OS), ORR, PFS, and the change in the indocyanine green retention rate at 15 min as measured before and after lenvatinib therapy. The trial was registered with the Japan Registry of Clinical Trials (s031190057). &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Between July 2019 and January 2021, 49 patients (42 oncologically unresectable patients and 7 technically unresectable patients) from 11 centers were enrolled. The ORR was 37.5% based on mRECIST and 12.5% based on RECIST version 1.1. Thirty-three patients underwent surgery (surgical resection rate: 67.3%) without perioperative mortality. The surgical resection rate was 76.2% for oncologically unresectable patients and 14.3% for technically unresectable patients. The 1-year OS rate and median PFS were 75.9% and 7.2 months, respectively, with a median follow-up period of 9.3 months. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; The relatively high surgical resection rate seen in this study suggests the safety and feasibility of lenvatinib therapy followed by surgical resection for patients with oncologically or technically unresectable HCC.
Identification of patients with favorable prognosis after resection in intermediate-stage-hepatocellular carcinoma
Authors: Han Ah Lee, Minjong Lee, Jeong-Ju Yoo, Ho Soo Chun, Yewan Park, Hwi Young Kim, Tae Hun Kim, Yeon Seok Seo, Dong Hyun Sinn
Journal: International Journal of Surgery (2023)

Backgrounds: It is unclear which patients benefit from resection in intermediate-stage-hepatocellular carcinoma (HCC). The authors aimed to identify high-risk patients for early recurrence among patients with resectable intermediate-stage HCC. Methods: This multicenter retrospective study included patients who underwent resection or trans-arterial chemoembolization (TACE) for intermediate-stage HCC (2008–2019). Multivariable Cox proportional analysis was performed to identify high-risk patients when treated with resection. A prediction score for 2-year recurrence-free survival (RFS) was developed using the training cohort and validated. The 2-year RFS in each risk group was compared with that in TACE group, after propensity score matching (PSM). Results: A total of 1686 patients were included (480 and 1206 patients in the resection and TACE groups). During a median follow-up of 31.4 months, the 2-year RFS was significantly higher in the resection (47.7%) than in the TACE group (19.8%) [adjusted hazard ratio (aHR)=1.471, 95% CI: 1.199–1.803, P &lt;0.001). On multivariate analysis, alpha-fetoprotein ≥5.0 ng/ml (aHR=0.202), ALBI grade ≥2 (aHR=0.709), tumor number ≥3 (aHR=0.404), and maximal tumor size ≥5 cm (aHR=0.323) were significantly associated with the lower risk of 2-year RFS in the resection group. The newly developed Surgery Risk score in BCLC-B (SR-B score) with four significant risk factors showed an area under the curve of 0.801 for the 2-year RFS and was validated. Based on the SR-B score, low-risk patients had a significantly higher 2-year RFS (training: aHR=5.834; validation: aHR=5.675) than high-risk patients (all P &lt;0.001) did. In a PSM cohort, a low-risk resection group had a significantly higher (aHR=3.891); a high-risk resection group had a comparable 2-year RFS to those treated with TACE (aHR=0.816). Conclusions: Resection may be beneficial for resectable intermediate-stage HCC based on the SR-B score.
A commentary on'Re: Is ChatGPT a qualified thoracic surgeon assistant?'
Authors: Shou-xiang Weng, Hai-hong Zheng, Qing-xin Yu, Jiao-chen Wang
Journal: International Journal of Surgery (2023)

aDepartment of pathology, Taizhou Hospital, Wenzhou Medical University, Linhai, Zhejiang Province, 317000, China bDepartment of pathology, Ningbo Clinical Pathology Diagnosis Center, Ningbo City, Zhejiang Province, 315211, China Shou-xiang Weng and Hai-hong Zheng: Both authors contributed equally to this work and are listed as co-first authors. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding Author. Address: Department of pathology, Ningbo Clinical Pathology Diagnosis Center, Ningbo City, Zhejiang Province, 315211, China. E-mail address: [email protected] (Q.-X. Yu). *Corresponding Author. Address: Department of pathology, Taizhou Hospital, Wenzhou Medical University, Linhai, Zhejiang Province, 317000, China. E-mail address: [email protected] (J.-C. Wang). This is an open access article distributed under the Creative Commons Attribution-ShareAlike License 4.0, which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-sa/4.0/
One Mutation to Rule Them All: Mutant KRAS Controls Tumor Intrinsic and Microenvironment Signaling
Authors: Sören Müller, Akshay T. Krishnamurty
Journal: Cancer Research (2023)

Abstract In a recent study published in Cancer Discovery, Hsu and colleagues employ an elegant combination of single-cell and bulk RNA sequencing experiments from mouse and human colorectal cancer samples, patient-derived organoids, two-dimensional in vitro systems, and in vivo validation in genetically engineered colorectal cancer mouse models to investigate how mutant KRAS (KRAS*) impacts the tumor microenvironment. They identify a molecular signaling cascade downstream of KRAS* that activates a specific program of lipid-rich cancer-associated fibroblasts, promoting tumor angiogenesis and progression. These findings may lead to new therapeutic strategies for patients with colorectal cancer with KRAS*.
Letter to the Editor: Alcohol-induced extracellular ASC specks perpetuate liver inflammation and damage in alcohol-associated hepatitis even after alcohol cessation
Authors: Jiayan Shen, Kaiyue Zhang, Mengyang Liu, Tao Wang
Journal: Hepatology (2023)

To the editor, We read with great interest the article by Ribeiro et al, that investigated the role of extracellular ASC (ex-ASC) specks in prolonged systemic and liver inflammation in alcohol-associated hepatitis. The authors concluded that the presence of NOD-like receptor family, pyrin domain–containing protein 3 (NLRP3) in ex-ASC specks is essential to amplify the sustained inflammasome activation and IL-1β production in alcohol-induced liver inflammation.1 However, we have some concerns about this conclusion. First, the current study reported that the low level of NLRP3 in hepatocyte-derived apoptosis-associated speck-like protein containing a CARD (ASC) specks was responsible for the different inflammasome activation effects between macrophages and hepatocytes. However, as shown in Figure 6F of Ribeiro et al, even if the NLRP3-overexpressing hepatocyte-derived ASC specks still failed to induce IL-1β release, a very limited explanation was provided for this result. Therefore, whether NLRP3 is critical in mediating ex-ASC specks–induced persistent inflammation in adjacent cells remains to be further clarified. Importantly, it would be more convincing to evaluate the effect of ASC specks derived from NLRP3-deficient macrophages on inflammation activation in both macrophages and hepatocytes. Second, only the protein composition of ASC specks was analyzed in macrophage and hepatocyte-derived ASC specks, while the oligomerization degree of ASC specks was not mentioned. Of note, recent studies have shown that the oligomeric states of ex-ASC specks are crucial in regulating inflammasome activation. ASC specks with a low degree of oligomerization are more prone to interaction with pro-caspase-1 and promote its activation.2 Moreover, the ASC oligomers can change their structure independently of NLRP3 to promote the recruitment of pro-caspase-1.3 Thus, to fully explain the different biological effects between macrophage- and hepatocyte-derived ASC specks, it is necessary to determine the oligomerization degree of ex-ASC specks in depth, which will have a notable impact on the final result. Third, in this research, MCC950 inhibition is not sufficient to prove that NLRP3 level in liver-derived ex-ASC specks is critical in amplifying systemic and liver inflammation in vivo. Since other tissues may also contribute to the release of ex-ASC specks to circulation. Therefore, further validation is needed, such as using myeloid-cell-specific or hepatocyte-specific NLRP3-deficient mice to unveil the role of NLRP3 in macrophage and hepatocyte-derived ex-ASC specks on alcohol-induced adjacent cell inflammation. In summary, this study provides a novel discovery on the role of ex-ASC specks in sustained inflammation in alcohol-associated hepatitis. However, further studies are required concerning the above issues to enhance the conclusions of this study.
A Multiethnic Germline–Somatic Association Database Deciphers Multilayered and Interconnected Genetic Mutations in Cancer
Authors: Junyi Xin, Zongchao Mo, Ruichao Chai, Wei Hua, Jiguang Wang
Journal: Cancer Research (2023)

Abstract Inherited germline and acquired somatic alterations can both promote human tumor development. Elucidating the cooperation between somatic and germline genetic alterations that drive tumorigenesis could help inform precision cancer prevention and treatment strategies. Here, leveraging genomic genotyping and sequencing data from 9,029 patients with cancer with European, East Asian, and African ancestry, we performed a pan-cancer analysis to evaluate the associations between germline SNPs and somatic alterations, including single-nucleotide variant and small insertion/deletion mutations, copy-number variation, tumor mutational burden, and mutational signatures. Genome-wide significant germline–somatic pairs were abundant, and most of the associations were observed in one cancer type and one ancestry group. A user-friendly interactive Multiethnic Germline–Somatic Association (MGSA) database (http://wanglab-hkust.cn:3838/MGSA/) was developed, which can be used to query, browse, and download the results of the association analyses. Moreover, the MGSA database offers additional survival analysis and functional annotation. Together, this work provides a resource for uncovering the clinical and biological roles of associations between germline variants and somatic alterations in human cancer. Significance: Comprehensive analysis of connections between germline variants and somatic events in cancer offers a resource for investigating the functional significance of genetic mutations and exploring genetic factors contributing to racial disparities.